Home Health Care and Local Government — A Growing Burden on NYC’s Serfs

Not long ago, I read about therapists getting arrested for stealing from programs for developmentally disadvantaged children, overbilling and not providing the services for which they had been paid.

https://www.audacy.com/1010wins/news/local/9-nyc-therapists-stole-usd3-3m-from-child-development-program

While I can’t find it now, I distinctly remember one of the articles saying that the crew had paused their scheme for a while in 2014, after another group had been caught doing the same thing.  Were the federal authorities really going to do something about this?  (They don’t have to worry about the state authorities, as NY state politicians are pro-fraud at the expense of the serfs, in exchange for political support).  After a year or two, the scammers decided the answer was no and resumed their criminal activities.

Meanwhile, the federal government was also investigating home health agencies for defrauding Medicaid.  The investigation took place in 2020, and ended late that year.

https://www.justice.gov/usao-sdny/pr/10-defendants-arrested-home-health-aide-fraud-scheme

“Money that’s earmarked for Medicaid-approved services, and fraudulently paid out to those who don’t render these services, is a crime that’s ultimately paid for by taxpayers themselves. In this case, as we allege, there were even patients involved in the kickback scheme who were willing to play along with the no-show scam in order to earn a few extra bucks. With a nearly $5 billion increase in managed long-term care plan spending recorded over a recent six-year period, the money paid out to those charged today is no drop in the bucket.”

So, was there a pause in New York City’s stunning home health care boom?  And did that pause subsequently end?

There and Here, Generation Greed Wants Everything but Refuses to Pay For Anything

Who, in a decade or two, will want the job of changing former President Donald Trump’s diapers, and who will have to pay for it?  

As I’ve said for years, The Donald is THE MAN of his generation.  A generation that came to interpret freedom as freedom from responsibility, to a greater extent than the generations before or after.  For those on the so-called “right,” it was freedom from social responsibility — to the community through paying taxes, to the planet by conserving natural resources, and even, it turns out, to those around them by wearing masks and getting vaccinated.  For those in the so-called “left” it was freedom from personal responsibility, to family members, or non-family progeny, when personal fulfillment, or sexual gratification, or just wanting to get high made that responsibility burdensome.  That has been the story, but not the fact.  In reality Trump, like the majority of his generation, was against any responsibility at all, social or personal.  Eventually, however, he and those of his generation will age to the point where they require custodial care, care that is either hugely expensive or personally draining to provide.  To be provided and paid for by whom?

I bring this up again because it would appear that in the UK, the generation that demanded lower taxes on itself is now demanding additional old age care for itself, paid for exclusively by the less well of generations to follow. Generations already on the wrong end of slashing social benefits for children, while putting a triple lock on a guarantee of benefits for aging adults.  Thus continuing to align Generation Greed’s economic, social and political choices with what, at least here in the United States, have been the personal and family choices of many, if not most.  All while engaging in a culture war to distract attention from what they, collectively, have done.  But there, unlike here in the U.S., generational inequities are at least talked about.

If you happen to be a comedy writer or comedic playwright, hold that thought about Trump’s last days.  I’ll have a suggestion for you at the end of this post, one that could bring 40 years of economic and social trends home to the later-born in a way that perhaps lots of boring data and analysis that you’ll have to get through first does not.